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Found 15765 cases where Vaccine is PNC13

Case Details (Reverse Sorted by Appearance Date)

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VAERS ID:604738 (history)  Vaccinated:2015-10-09
Age:70.0  Onset:2015-10-09, Days after vaccination: 0
Gender:Female  Submitted:2015-10-15, Days after onset: 6
Location:Georgia  Entered:2015-10-26, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI441AB2IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM032110IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site nodule, Injection site reaction, Pain in extremity, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Knot witnedness to Lt deltoid at injection site afternoon of 10-09-15. Rash (sm red bumps) started at injection site 10-10-15. Knot no longer there an 10-10-15 but arm sore. Rash began to spread down the arm to the waist and to Rt arm. Also (rash sm red bumps) on face. C/o itching (rash).

VAERS ID:604749 (history)  Vaccinated:2015-10-21
Age:69.0  Onset:2015-10-21, Days after vaccination: 0
Gender:Female  Submitted:2015-10-26, Days after onset: 5
Location:Virginia  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No; Hip replacement on June 2015
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR  UNLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  UNRA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Middle insomnia, Mobility decreased, Musculoskeletal stiffness, Pain, Pain in extremity
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Noticed problems, more than expected, on right arm. Stiffness and inability to move - like paralysis - on shoulder joint. Had enough pain to call nurse on hotline for pain. Recommended ADVIL and TYLENOL. The medicine helped a little but got worse. Even though was taking ADVIL every 4-6 hours still getting up at night. Has problems moving arm; can''t lift it on its own higher than the chest. Called doctor the next day who recommended to continue to take ADVIL. It doesn''t seem to be getting better. Pain is going down arm; pain in joint is steady but down arm is intermittent. Pain level is at 4/10 with ADVIL.

VAERS ID:604750 (history)  Vaccinated:2015-10-20
Age:66.0  Onset:2015-10-20, Days after vaccination: 0
Gender:Male  Submitted:2015-10-20, Days after onset: 0
Location:Iowa  Entered:2015-10-26, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Lidocaine; Novacaine; HBP; Cholesterol
Diagnostic Lab Data: BP, blood sugar, pulse
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUI481AA0IMRA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM130670IMLA
Administered by: Other     Purchased by: Private
Symptoms: Blood glucose, Loss of consciousness, Respiratory arrest, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Respiratory failure (narrow)
Write-up: Patient stopped breathing for 30-45 seconds lost consciousness, unresponsive. Did not initiate CPR, but pressed chest to force exhaulation. Called 911. Patient had reqained consciousness by the time ambulance arrived.

VAERS ID:604753 (history)  Vaccinated:2015-10-15
Age:76.0  Onset:0000-00-00
Gender:Female  Submitted:2015-10-19
Location:Alabama  Entered:2015-10-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Contacted PCP who said to monitor and take ibuprofen
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI478AA0IMRA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM068980IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Slightly raised red area about the size of my palm. Warm to touch.

VAERS ID:604754 (history)  Vaccinated:2015-10-15
Age:80.0  Onset:2015-10-16, Days after vaccination: 1
Gender:Female  Submitted:2015-10-19, Days after onset: 3
Location:Pennsylvania  Entered:2015-10-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: HTN
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUI459AB IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL99275 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness and swelling upper left arm, pt denies fever.

VAERS ID:604773 (history)  Vaccinated:2015-10-14
Age:73.0  Onset:2015-10-14, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Minnesota  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Chills, vomiting~Influenza (Seasonal) (no brand name)~1~0.00~Patient
Other Medications: See attached list
Current Illness: None
Preexisting Conditions: Type II DM; COPD; CHF; Hypothyroidism with goiter
Diagnostic Lab Data: CBC WNL; Comp panel WNL except glucose 110
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUT442AB SYRLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL992750SYRLA
Administered by: Private     Purchased by: Unknown
Symptoms: Blood glucose normal, Chills, Full blood count normal, Headache, Metabolic function test normal, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Fever low grade, chills, headache, myalgia 1.5 hours after injection. No local reaction noted.

VAERS ID:604780 (history)  Vaccinated:2015-10-13
Age:69.0  Onset:0000-00-00
Gender:Female  Submitted:2015-10-16
Location:Massachusetts  Entered:2015-10-26, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI478AAB IMRA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHMO6898 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt reports severe headache that lasted almost all day, polymyalgia, no fever, injection site was sore, but no swellng. At time of reports no headaches n/v or weakness.

VAERS ID:604827 (history)  Vaccinated:2015-10-20
Age:80.0  Onset:0000-00-00
Gender:Female  Submitted:2015-10-26
Location:Louisiana  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~Zoster (Zostavax)~1~79.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS 0UNLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH 0SYRRA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Fatigue, Injection site pain, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Vaccine (PREVNAR 13) administered in (R) deltoid on 10/20/15. Following day, temp 99.8, fatigue, pain at injection site. Red, itchy rash below injection site 10/25/15.

VAERS ID:604838 (history)  Vaccinated:2015-10-16
Age:1.0  Onset:2015-10-24, Days after vaccination: 8
Gender:Male  Submitted:2015-10-26, Days after onset: 2
Location:Massachusetts  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU5319DA0IMRL
HEPA: HEP A (VAQTA)MERCK & CO. INC.L0027170IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.L0013360SCLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL581533IMRL
Administered by: Private     Purchased by: Public
Symptoms: Body temperature increased, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow)
Write-up: Red dots over trunk and face 10 days post MMR temp 101.1.

VAERS ID:604861 (history)  Vaccinated:2015-10-12
Age:1.0  Onset:2015-10-12, Days after vaccination: 0
Gender:Male  Submitted:2015-10-26, Days after onset: 14
Location:Colorado  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine 1mg; desonide 0.05%; hydroxyzine HCI 10mg/5mL; triamcinolone acetonide
Current Illness: N/A
Preexisting Conditions: Eczema, Patent Foramen Ovale, Seasonal Allergies
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU5319DA0IMRL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS9CJ5Y0IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.L0028672IMRL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.L0083550SCLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL992593IMRL
Administered by: Private     Purchased by: Public
Symptoms: Cough, Irritability, Nasopharyngitis, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: 10/12/2015: fever 101.8. 10/13/2015: fever 101.3. 10/14/2015: fever 102.5 fussy, cold like symptoms. 10/15/2015: fever 102.9 vomiting, cough, fussy, rash - seen by Dr.

VAERS ID:604866 (history)  Vaccinated:2015-10-16
Age:81.0  Onset:2015-10-20, Days after vaccination: 4
Gender:Female  Submitted:2015-10-26, Days after onset: 6
Location:Virginia  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LEXAPRO
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL935920IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Peripheral swelling, Rash erythematous, Rash pruritic
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: SWOLLEN ARM AND HAND, ITCHY RED RASH.

VAERS ID:604876 (history)  Vaccinated:2015-10-20
Age:94.0  Onset:2015-10-22, Days after vaccination: 2
Gender:Female  Submitted:2015-10-26, Days after onset: 4
Location:Massachusetts  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, asa, levothyroxine, Lasix, metoprolol tartrate, omeprazole
Current Illness: No
Preexisting Conditions: Yes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM068990IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site rash, Injection site swelling, Injection site warmth, Malaise
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Malaise, warm constant red rash on left upper arm, swollen.

VAERS ID:604902 (history)  Vaccinated:2015-10-19
Age:88.0  Onset:0000-00-00
Gender:Female  Submitted:2015-10-19
Location:Colorado  Entered:2015-10-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Sulfa allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUI448AA IMRA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM03211 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Contusion, Injection site induration, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: After a week, pt, reported severe itching, to where she bruised her skin, reddish-purple from elbow to shoulder. Stated it was hard at injection site, and very warm to touch. This was due to PREVNAR - upper left arm affected.

VAERS ID:604906 (history)  Vaccinated:2015-09-30
Age:84.0  Onset:2015-10-20, Days after vaccination: 20
Gender:Female  Submitted:2015-10-26, Days after onset: 6
Location:Wisconsin  Entered:2015-10-26
Life Threatening? No
Died? Yes
   Date died: 2015-10-20
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: COPD, STAGE 3 KIDNEY DISEASE, hx lung ca, anemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS25L53 IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  IMLA
Administered by: Public     Purchased by: Private
Symptoms: Death, Multimorbidity
SMQs:
Write-up: Death - pt had co-morbities at the time, poss pneumonia, pneumothorax. Death occurred on a subsequent admission not the same as Prevnar 13 administration.

VAERS ID:604925 (history)  Vaccinated:2015-10-02
Age:68.0  Onset:2015-10-04, Days after vaccination: 2
Gender:Male  Submitted:2015-10-26, Days after onset: 22
Location:North Carolina  Entered:2015-10-26
Life Threatening? No
Died? Yes
   Date died: 2015-10-12
   Days after onset: 8
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole 20mg capsule 1 po qd; Oxycodone 20mg 1q4h po prn; Oxybutynin ER 10mg 1po qd; Amlodipine 5mg 1 po qd; Lisinopril 10mg 1 po qd; Famotidine 20 mg 1poqhs; Alprazolam 0.5mg 1po tid; Sertraline 100mg 1po bid
Current Illness: None
Preexisting Conditions: Not Known Allergy
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL992621IMLA
Administered by: Other     Purchased by: Public
Symptoms: Death, Pneumonia
SMQs:, Eosinophilic pneumonia (broad)
Write-up: As per patient spouse, He was admitted in hospital on 10/04/2015 due to pnuemonia and died on 10/12/2015. We don''t have hospital report.

VAERS ID:604930 (history)  Vaccinated:2015-10-22
Age:65.0  Onset:2015-10-26, Days after vaccination: 4
Gender:Female  Submitted:2015-10-26, Days after onset: 0
Location:California  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methadone 10mg, Gabapentin 400mg, Wellbutrin XL 300mg, Linzess 145mcg, Seroquel 50mg, Janumet XR 50-500mg, Aldactone 25mg, Lisinopril 20mg
Current Illness: Diabetes
Preexisting Conditions: Statin Drugs, Penicillins, Nuts, Bee Stings
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUI454AA IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL99273 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site reaction
SMQs:
Write-up: Patient presented to her physcian with injection site reaction. Provider gave her antibiotic (Bactrim) in case there could have been a probable infection.

VAERS ID:604933 (history)  Vaccinated:2015-10-08
Age:66.0  Onset:2015-10-09, Days after vaccination: 1
Gender:Female  Submitted:2015-10-26, Days after onset: 17
Location:Kentucky  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Diovan hct 160-12.5, Synthroid 75mcg
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Ultrasound of right arm
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDU566060IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL992710IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.L0249990SCRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site swelling, Peripheral swelling, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling of upper and lower right arm.

VAERS ID:604944 (history)  Vaccinated:2015-08-25
Age:0.2  Onset:2015-08-25, Days after vaccination: 0
Gender:Male  Submitted:2015-10-26, Days after onset: 62
Location:Texas  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: Abdominal ultrasound-normal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC4917AB0IMLL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.K0202161IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL364810IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.K0201810PO 
Administered by: Unknown     Purchased by: Public
Symptoms: Abdominal pain upper, Crying, Ultrasound abdomen normal
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad)
Write-up: Stomach cramping, inconsolable crying requiring ER visit.

VAERS ID:604946 (history)  Vaccinated:2015-09-18
Age:65.0  Onset:2015-09-18, Days after vaccination: 0
Gender:Female  Submitted:2015-10-26, Days after onset: 38
Location:North Carolina  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL777771IMRA
Administered by: Other     Purchased by: Other
Symptoms: Joint injury, Pain in extremity, Skeletal injury
SMQs:, Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Patient states arm still hurts from shot, went to doctor and was told there was joint/bone damage resulting from shot administration.

VAERS ID:604955 (history)  Vaccinated:2015-10-13
Age:93.0  Onset:2015-10-15, Days after vaccination: 2
Gender:Female  Submitted:2015-10-26, Days after onset: 11
Location:California  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations: 1974~Tetanus Toxoid (no brand name)~UN~0.00~Patient
Other Medications: Furosemide; K-Tab; warfarin; simvastatin; amlodipine; albuterol; baby aspirin
Current Illness:
Preexisting Conditions: Allergies = Lisinopril; Salicylates; Tetanus antitoxin
Diagnostic Lab Data: Cellulitis; culture (no results yet); Xray; No fever
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS151580119UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL99261 UNUN
Administered by: Other     Purchased by: Unknown
Symptoms: Asthenia, Cellulitis, Culture, Skin infection, X-ray
SMQs:, Guillain-Barre syndrome (broad)
Write-up: Infection after receiving the pneumonia vaccine (PCV13). Shot on 10/13/15 went to urgent care 3x was hospitalized on 10/23/15 for skin infection - on antibiotics until Nov. 2 - very weak.

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